This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Determine if Pioglitazone plus life-style intervention will be more effective than placebo plus lifestyle intervention in reducing triglyceride levels in antipsychotic treated schizophrenic patients with impaired (>150 mg/dL) or elevated (>200 mg/dL) triglyceride levels. Determine if Pioglitazone plus life style intervention will be more effective than placebo plus lifestyle intervention in increasing HDL and decreasing two atherosclerotic risk ratios (Total cholesterol/HDL and triglycerides/HDL). Determine if Pioglitazone plus life-style intervention will be more effective than placebo plus lifestyle intervention in reducing indices of impaired glucose metabolism (fasting glucose levels >100 mg/dL, Hb1Ac levels >6.4, 2 hr glucose values in glucose tolerance test >140 mg/dL). Determine if the degree of impaired glucose tolerance as assessed by fasting glucose levels and 2 hr glucose levels on glucose tolerance test will be significantly negatively correlated with immediate and delayed verbal memory performance (as measured by list learning and story recall on the RBANS.) Determine if the degree of improvement from impaired glucose tolerance (fasting glucose, and 2 hr glucose in glucose tolerance test)will be correlated with improved performance in verbal memory as measured by the tests noted in hypothesis. Determine if the degree of memory improvement (same day pre-glucose baseline vs. 2 hr) during GTT glucose load, on paired word and short story of the RANDT Memory Scale will be correlated with the degree of baseline cognitive deficit and the degree of impaired glucose tolerance.